07/18/2008

In which I lose my Kool

I don't normally respond publicly to crotchety comments, being for the most part a hundred-flowers-bloomer, only, you know, without the appalling violence and the destruction of an entire nation's ideological integrity, but I'm going to do it now, because one I received the other day has really gotten to me.

I've had three wonderful all natural vaginal births with midwives
and the experiences were transcendant. It is not something I would have
given up because of a remote statistical risk that something even more
remote would happen. And I certainly would not have given it up because
I was being pressured by authoritarian doctors who are clearly
practicing CYA medicine.

You're a smart cookie, Julie, so stop drinking the Koolaid.

Hey! Kool-Aid!

Oh, yeeaaaaaaaaah.

But that's Doctor Kool-Aid to you, missy.

I'll start with the commenter's last line first. Let us leave aside for the moment the obvious problem with the metaphor. On the gestational diabetes diet, which is supplemented twice daily with insulin, I assure you that I am consuming little in the way of cookies and even less in the way of Kool-Aid. This single line immediately inclines me to disregard the commenter's...advice, would you call it?...because, duh, with her words alone she is obviously trying to kill me.

But like I said, I'm a hundred-flowers-bloomer, so I want to give her comment fair consideration. So let's skip back to the beginning. "I've had three wonderful all-natural vaginal births with midwives and the experiences were transcendent." Well, all right, I can't immediately see how someone with this experience might be inclined to identify with my situation, but maybe there's some common thread there...

Let's see. Three births? Nope. Just the one for me. Wonderful? Uhhhh. No. Vaginal? Wasn't an option from week 20 onward. Midwives? Hahahaha, ohhhh. All-natural? Well, no more so than whatever the hell Kraft used to put in its now-discontinued Berry Blue. (My money's on sugar, powdered rhinoceros horn, purest crystal meth, and either curaçao or windshield wiper fluid. Or possibly engine coolant, because despite some hot childhood summers on the Mississippi delta I don't remember my radiator ever overheating.)

As to the transcendent part, on that we almost converge, because between the demerol, the mag, and the adrenaline born of pure panic, I was high as a goddamned kite. So I'll let the other dissimilarities go. Obviously we are steadfast comrades happily traveling a similar reproductive path. Let us proceed!

The commenter continues: "It is not something I would have
given up because of a remote statistical risk that something even more
remote would happen."

I'm not sure where to go with this one. I could talk about how infertile people seem, in my observational experience, to be more risk averse than the general population when it comes to pregnancy and delivery. (I leave it to the reader to tease out the ever-so-complicated reasons that might pertain.) I could talk about my own obstetrical history, which reads overall like a Ripley's Believe This Completely Unlikely but Totally True Wack-Ass Shit or Not of conception, gestation, and birth, and how even in a pregnancy that has gone thus far without any hitch whatsoever, I find it hard to leave much to chance. Or I could simply point that the commenter and I are different people, and that reasonable people can disagree without presuming each other ill informed, reckless, stupid, or all of the above.

There's still a bit more, just before the part where the commenter offers me a sugar coma on a chased silver platter: "And I certainly would not have given it up because
I was being pressured by authoritarian doctors who are clearly
practicing CYA medicine."

There's an awful lot of presumption in that statement. I would not call my doctors authoritarian by any means, nor have I felt pressured. I've found them to be conscientious in informing me of the risks as they understand them, but I've also found them willing to follow my cues, and to put off making any recommendations until the last minute. ("After all, even if we do schedule a C-section," Tuesday's doctor told me cheerfully, "your body might well have other ideas before you've even packed a bag." Could be. We all know my body's just brimming with good ideas.)

As to the charge that they are practicing cover-your-ass medicine, I don't know that I agree. There is perhaps the smallest kernel of truth in the charge, because what doctor wants to expose a patient to additional risk, whether the reason be ethical or financial? But my stronger conviction is that they're practicing cover-Julie's-and-her-baby's-respective-asses medicine. I've said several times that I'm not all that picky about how the baby is born, that it is more important to me to minimize the risk of harm — from uterine rupture to neonatal injury, encompassing an awful lot in between — to both of us than it is to have "a wonderful all-natural vaginal birth." I appreciate it that they're taking my statements seriously, which is frankly more than the commenter has done. And before I provoke a spate of accusations that I cannot possibly have adequately considered the risks of a caesarean birth, well, let me just say that at this point, given what I've learned about my particular situation, you pick your poison. Or your flavor of Kool-Aid. (Sharkleberry Fin, straight up, no contest.)

Speaking of Kool-Aid, I am condensing the part of this rant I'd planned to devote to the charge that by even considering a surgical delivery, I must have bought into some Jonestown-style delusion. I will say in short that it's a tired analogy, an insulting premise, and an outrageous aspersion to cast upon a blameless "fruit"-"flavored" decoction. Why, if I were Dr. Portly Brimming Vessel Strangely Endowed with Fully Articulated Limbs But Inexplicably Denied Cranial Sutures, I'd sue. Especially since the poor misguided dead in Guyana drank not Kool-Aid but Flavor Aid, a fact the good people at Kraft would thank you to remember.

Finally — finally! — I'll wrap up by saying that I've learned something priceless from my own experience and from the stories other readers have generously shared. Ready? It's this: If you happened to get the three glorious vaginal births of your dreams, or the fairy tale pregnancy, or the easy conception, or no miscarriages, or, hell, a live baby of any description, it's not necessarily because you were smart or careful or diligent or determined, even if you were indeed all of these things. Some of them may have contributed to your positive outcome, but ultimately, it's because you were really fucking lucky. And using that great good fortune as a stick to poke others with isn't what I'd call sweet, cool, or particularly refreshing. (Though even I must admit that it sounds somewhat more appetizing than something called Pink Swimmingo, which I cannot imagine tasting like anything but brackish water, shrimp, and a froth of Everglades scum.)

SPECIAL BONUS MINI-RANT: Another comment that made me see Rock-a-dile Red! "I was seeing a midwife, suspected GD...went on to birth a 10.10 baby at home no worries at all. my biggest
baby, my easiest best, most rewarding birth. Having him at home
definatly lowered my risks for all nightmares that you speak of with
larger babies...Then there is the whole idea that GD is not actually
a real thing - OF COURSE the way your body metabolizes sugar changes
when you are pregnant. Has your doctor addressed your diet at all or is
he just planning the section because thats easier and avoids actual
relationship with the patient? Don't buy into this garbage line - all that matters is a healthy baby.
YOU matter, the way you are treated at your birth matters and will
affect you the rest of your life. Fight for what you want - demand it -
don't give in to the rhetoric."

Please, what I want is to be given the benefit of the doubt: that I have sought and secured good medical care; that I am capable of making informed decisions; that like any other self-actualized human being I would insist on being treated with respect and consideration; and that I am not weakly capitulating because I am intimidated by a man in a white coat. Or an overflowing glass pitcher. Whichever.

Posted by Julie at 11:23:54 AM

Comments

In which I lose my Kool

I don't normally respond publicly to crotchety comments, being for the most part a hundred-flowers-bloomer, only, you know, without the appalling violence and the destruction of an entire nation's ideological integrity, but I'm going to do it now, because one I received the other day has really gotten to me.

I've had three wonderful all natural vaginal births with midwives
and the experiences were transcendant. It is not something I would have
given up because of a remote statistical risk that something even more
remote would happen. And I certainly would not have given it up because
I was being pressured by authoritarian doctors who are clearly
practicing CYA medicine.

You're a smart cookie, Julie, so stop drinking the Koolaid.

Hey! Kool-Aid!

Oh, yeeaaaaaaaaah.

But that's Doctor Kool-Aid to you, missy.

I'll start with the commenter's last line first. Let us leave aside for the moment the obvious problem with the metaphor. On the gestational diabetes diet, which is supplemented twice daily with insulin, I assure you that I am consuming little in the way of cookies and even less in the way of Kool-Aid. This single line immediately inclines me to disregard the commenter's...advice, would you call it?...because, duh, with her words alone she is obviously trying to kill me.

But like I said, I'm a hundred-flowers-bloomer, so I want to give her comment fair consideration. So let's skip back to the beginning. "I've had three wonderful all-natural vaginal births with midwives and the experiences were transcendent." Well, all right, I can't immediately see how someone with this experience might be inclined to identify with my situation, but maybe there's some common thread there...

Let's see. Three births? Nope. Just the one for me. Wonderful? Uhhhh. No. Vaginal? Wasn't an option from week 20 onward. Midwives? Hahahaha, ohhhh. All-natural? Well, no more so than whatever the hell Kraft used to put in its now-discontinued Berry Blue. (My money's on sugar, powdered rhinoceros horn, purest crystal meth, and either curaçao or windshield wiper fluid. Or possibly engine coolant, because despite some hot childhood summers on the Mississippi delta I don't remember my radiator ever overheating.)

As to the transcendent part, on that we almost converge, because between the demerol, the mag, and the adrenaline born of pure panic, I was high as a goddamned kite. So I'll let the other dissimilarities go. Obviously we are steadfast comrades happily traveling a similar reproductive path. Let us proceed!

The commenter continues: "It is not something I would have
given up because of a remote statistical risk that something even more
remote would happen."

I'm not sure where to go with this one. I could talk about how infertile people seem, in my observational experience, to be more risk averse than the general population when it comes to pregnancy and delivery. (I leave it to the reader to tease out the ever-so-complicated reasons that might pertain.) I could talk about my own obstetrical history, which reads overall like a Ripley's Believe This Completely Unlikely but Totally True Wack-Ass Shit or Not of conception, gestation, and birth, and how even in a pregnancy that has gone thus far without any hitch whatsoever, I find it hard to leave much to chance. Or I could simply point that the commenter and I are different people, and that reasonable people can disagree without presuming each other ill informed, reckless, stupid, or all of the above.

There's still a bit more, just before the part where the commenter offers me a sugar coma on a chased silver platter: "And I certainly would not have given it up because
I was being pressured by authoritarian doctors who are clearly
practicing CYA medicine."

There's an awful lot of presumption in that statement. I would not call my doctors authoritarian by any means, nor have I felt pressured. I've found them to be conscientious in informing me of the risks as they understand them, but I've also found them willing to follow my cues, and to put off making any recommendations until the last minute. ("After all, even if we do schedule a C-section," Tuesday's doctor told me cheerfully, "your body might well have other ideas before you've even packed a bag." Could be. We all know my body's just brimming with good ideas.)

As to the charge that they are practicing cover-your-ass medicine, I don't know that I agree. There is perhaps the smallest kernel of truth in the charge, because what doctor wants to expose a patient to additional risk, whether the reason be ethical or financial? But my stronger conviction is that they're practicing cover-Julie's-and-her-baby's-respective-asses medicine. I've said several times that I'm not all that picky about how the baby is born, that it is more important to me to minimize the risk of harm — from uterine rupture to neonatal injury, encompassing an awful lot in between — to both of us than it is to have "a wonderful all-natural vaginal birth." I appreciate it that they're taking my statements seriously, which is frankly more than the commenter has done. And before I provoke a spate of accusations that I cannot possibly have adequately considered the risks of a caesarean birth, well, let me just say that at this point, given what I've learned about my particular situation, you pick your poison. Or your flavor of Kool-Aid. (Sharkleberry Fin, straight up, no contest.)

Speaking of Kool-Aid, I am condensing the part of this rant I'd planned to devote to the charge that by even considering a surgical delivery, I must have bought into some Jonestown-style delusion. I will say in short that it's a tired analogy, an insulting premise, and an outrageous aspersion to cast upon a blameless "fruit"-"flavored" decoction. Why, if I were Dr. Portly Brimming Vessel Strangely Endowed with Fully Articulated Limbs But Inexplicably Denied Cranial Sutures, I'd sue. Especially since the poor misguided dead in Guyana drank not Kool-Aid but Flavor Aid, a fact the good people at Kraft would thank you to remember.

Finally — finally! — I'll wrap up by saying that I've learned something priceless from my own experience and from the stories other readers have generously shared. Ready? It's this: If you happened to get the three glorious vaginal births of your dreams, or the fairy tale pregnancy, or the easy conception, or no miscarriages, or, hell, a live baby of any description, it's not necessarily because you were smart or careful or diligent or determined, even if you were indeed all of these things. Some of them may have contributed to your positive outcome, but ultimately, it's because you were really fucking lucky. And using that great good fortune as a stick to poke others with isn't what I'd call sweet, cool, or particularly refreshing. (Though even I must admit that it sounds somewhat more appetizing than something called Pink Swimmingo, which I cannot imagine tasting like anything but brackish water, shrimp, and a froth of Everglades scum.)

SPECIAL BONUS MINI-RANT: Another comment that made me see Rock-a-dile Red! "I was seeing a midwife, suspected GD...went on to birth a 10.10 baby at home no worries at all. my biggest
baby, my easiest best, most rewarding birth. Having him at home
definatly lowered my risks for all nightmares that you speak of with
larger babies...Then there is the whole idea that GD is not actually
a real thing - OF COURSE the way your body metabolizes sugar changes
when you are pregnant. Has your doctor addressed your diet at all or is
he just planning the section because thats easier and avoids actual
relationship with the patient? Don't buy into this garbage line - all that matters is a healthy baby.
YOU matter, the way you are treated at your birth matters and will
affect you the rest of your life. Fight for what you want - demand it -
don't give in to the rhetoric."

Please, what I want is to be given the benefit of the doubt: that I have sought and secured good medical care; that I am capable of making informed decisions; that like any other self-actualized human being I would insist on being treated with respect and consideration; and that I am not weakly capitulating because I am intimidated by a man in a white coat. Or an overflowing glass pitcher. Whichever.